Healthcare Provider Details

I. General information

NPI: 1124012067
Provider Name (Legal Business Name): ERNEST A. KENDRICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ERNEST A KENDRICK MD PA

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 FM 1092 RD STE 306
MISSOURI CITY TX
77459-1564
US

IV. Provider business mailing address

1306 FM 1092 RD STE 306
MISSOURI CITY TX
77459-1564
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-5814
  • Fax: 281-242-6714
Mailing address:
  • Phone: 281-242-5814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2019-0880
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.132017
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG19935
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number64539
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: